Sunday, 1 July 2012

The Price of Keeping Quiet - Bristol to Baltimore

This week the UK Department of Health published its interim report setting out how it intends to improve the care provided to vulnerable people in the future. The report was prompted by the scandal last year involving people with a learning disability who lived at the Winterbourne Care Home near Bristol. They suffered physical, mental and emotional abuse at the hands of the staff meant to be there to provide them with care. The report drew upon a review by the Care Quality Commission (CQC) of learning disability services at 150 NHS, private care and social care services which found almost 50% were not meeting government standards.

The CQC review was ordered after the abuse at the care home in Bristol was revealed by the BBC Panorama programme in 2011. Some of the staff working at Winterbourne tried to warn of the abuse taking place but were ignored. The report on Winterbourne View itself will be published later on this year so as not to interfere with the ongoing prosecutions. 9 people have admitted abuse charges and 2 others will face trial at Bristol Crown Court this summer. While no abuse on the scale of Winterbourne was found at the sites studied by the CQC, the report showed that there is compelling evidence that some people with learning disabilities are being failed by health and care services. However, I wonder if anyone responsible for the systematic failure at Winterbourne and places like it will ever get to face the music in court.

Reflecting on this failure to speak up I was reminded of the highly evocative and emotionally challenging Baltimore Holocaust Memorial I had visited weeks ago. The first thing one becomes aware of is the sculpture created by Joseph Sheppard. This is a statue which depicts the horror of the Holocaust by portraying emaciated bodies of the victims’ bodies contorted in a ball of flame. The base of the sculpture bears the quote from George Santayana:

Those who do not remember the past are destined to repeat it.

The attempted annihilation of the European Jewish population between 1933 and 1945, took the lives of 6 million Jews. The Holocaust was unique not just in its numerical magnitude. Gypsies, and those with a physical or mental handicap were also marked for death, homosexuals, Jehovah’s Witnesses, Soviet prisoners of war, Polish nationalists and resistance fighters were all tyrannized as part of the holocaust.

Many thousands of German citizens and nationals of other countries allied with the Germans were involved in the killing process either as guards at camps, members of mobile killing units, architects who designed gas chambers, engineers who built crematoria, railway personnel and bureaucrats who oversaw the distribution of the victim’s possessions. Although many of these perpetrators claimed they had no choice, there is no record of anyone being punished for refusing to participate in the killings. Many countries and neutral international agencies were aware of what was being done to Jews and other victims. Few, if any, were willing to speak out in protest.

At the back of the memorial are 2 walls bearing the words of Primo Levi from his book Survival in Auschwitz. Standing in the quiet and sunshine of Baltimore, I found reading these words a profoundly moving experience.

On both sides of the track, rows of red and white lights appeared, as far as the eye could see...

...with the rhythm of the wheels, with every human sound now silenced, we waited to see what would happen...

...in an instant, our women, our parents our children disappeared. We saw them for a brief while as an obscure mass at the other end of the platform

Then we saw nothing more

The full report into what went on in Winterbourne will be published in the autumn. The Department of Health interim report sets out clear actions which will be taken forward at a national level to help deliver the local change needed to ensure that people with learning disabilities or autism and behaviours that challenge can have the support they need to lead their lives like any other person, with the same opportunities and responsibilities, and to be treated with dignity and respect.

Whilst all parts of the health and social care system have a role to play in making this happen and every part of the system must work together to drive up standards, it will be equally important to ensure that individuals have a voice they can use and use with confidence and free from personal persecution if the horrors of the past are never to be repeated.